Provider Demographics
NPI:1437115441
Name:BROWN, MAUREEN (MSN, APRN, BC, FNP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSN, APRN, BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 E BROADWAY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8023
Mailing Address - Country:US
Mailing Address - Phone:572-442-2221
Mailing Address - Fax:573-449-8646
Practice Address - Street 1:1605 E BROADWAY
Practice Address - Street 2:SUITE 260
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8023
Practice Address - Country:US
Practice Address - Phone:572-442-2221
Practice Address - Fax:573-449-8646
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN070547208800000X
MO070547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1437115441Medicaid